Patient Engagement

Patient Engagement within Health Professions Admissions Processes

The goal of my AMS Phoenix Fellowship is to encourage patient engagement within admissions processes selecting for future health care professionals. One might say that today, patients are most commonly represented “in spirit” within admissions processes. I have chosen the term “in spirit” as the overarching goal of admissions is the selection of health care professionals with the capacity to one day deliver compassionate care to patients – yet patients rarely if ever are actually engaged in the selection. Educational institutions are most commonly the sole selection arbiters, not patients in this essential formative step for our health care systems.

Exploring how patients can participate as selection arbiters is a key aspect of my fellowship. As a first step in exploring this question I reflected upon my own previous admissions work that I undertook with Phoenix colleagues at the University of Toronto (U of T) MD program. My Phoenix colleagues are Drs. Mahan Kulasegaram, Nicole Woods and Tina Martimianakis. Along with another U of T colleague we developed the Modified Personal Interview (MPI). The MPI is a semi-structured interview. An essential selection task is the global assessment of applicants’ caring and conscientiousness competencies by faculty, university administrators and medical learners. The caring and conscientiousness competencies were chosen subsequent to a U of T Faculty of Health Sciences retreat identifying these competencies as universal admissions competencies for all health care professionals. Admissions interviewers were provided training. Furthermore, this training regarding use of these global competencies for applicant assessment provided a “teachable moment” for establishing the institutional value of caring, compassion and conscientiousness for all admissions interviewers.

We were successful in implementing the MPI and advancing the institutional value of caring, compassion and conscientiousness in applicant assessment. Upon personal reflection, however, patient engagement was not sought at any step along the developmental path towards implementation of the MPI. The MPI definitely demonstrates how patients are represented “in spirit” within admissions processes but are not directly engaged within these processes. In hindsight there were a range of patient engagement opportunities in our MPI development if only I had been attuned to them. Opportunities included the selection of the global competencies of caring and conscientiousness, admission interview question writing, participation as admissions interviewers and/or admissions MPI trainers. Would patients prioritize caring and conscientiousness competencies in similar fashion to our institution? Would patient experiences have broadened the perspectives of admissions interview questions and interviewer training? Finally, would patient interviewers have broadened and diversified our ratings of applicants? And these are only the opportunities that I can identify as a member of our institution. What alternative, additional opportunities and perspectives might have been identified and provided by patients, independent of our institution if they had been engaged to review the MPI? Or for that matter if they had been engaged from the very beginning in the co-development of the MPI.

The “science of patient input” is new and its application to admissions processes is even newer. A first developmental step for institutions interested in patient engagement within admissions would be a process of institutional reflection upon their approach to “in spirit” patient engagement to elucidate real patient engagement opportunities. My personal example is within medical school admissions. However, I consider institutional reflection of this type to be applicable across all of the health professions, across all learner levels plus to be applicable to the hiring processes for health care personnel in hospitals and other health care institutions.


About the author

Dr. Mark Hanson
  • AffiliationUniversity of Toronto
  • Twitter

Dr. Mark Hanson is a Child and Adolescent Psychiatrist at the Hospital for Sick Children and is Professor of Psychiatry at the University of Toronto. He is the Past Admissions Dean/Director at the University Of Toronto Faculty Of Medicine.

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